City of Newark v. JS
279 N.J. Super. 178, 652 A.2d 265 (1993)
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Rule of Law:
A person with a communicable disease may be involuntarily committed for treatment, but only if the government proves by clear and convincing evidence that the person poses a significant risk to others and that commitment is the least restrictive means available. Such a commitment must adhere to procedural due process safeguards analogous to those used for involuntary civil commitments of the mentally ill.
Facts:
- J.S. is a 40-year-old man who is homeless and suffers from both active tuberculosis (TB) and HIV disease.
- J.S. had a history of leaving the hospital against medical advice, failing to follow infection control protocols, and not completing his prescribed TB medication regimens.
- On one occasion, after being discharged, J.S. was placed in a taxi to a shelter, given a clinic appointment far from the shelter, and had no money, resulting in a missed appointment where he was labeled 'non-compliant.'
- Hospital authorities sought intervention from the City of Newark after J.S. expressed his intent to leave against medical advice while still contagious.
- While at the hospital, J.S. was found dressed in street clothes in the lobby and had previously wandered into the pediatrics ward.
- A sputum sample confirmed J.S. had active TB, a communicable disease transmitted through airborne droplets.
Procedural Posture:
- The City of Newark filed a verified complaint in the Superior Court of New Jersey, Law Division, Essex County.
- The plaintiff obtained an ex parte temporary commitment order and an order to show cause from the emergent duty judge, temporarily detaining J.S.
- A commitment hearing was held on the return of the order to show cause to determine if a final order of commitment should be issued.
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Issue:
Does the involuntary commitment of a person with active, communicable tuberculosis to a hospital for treatment violate their due process rights or the Americans with Disabilities Act (ADA) when there is evidence of non-compliance with treatment and no less restrictive alternative for isolation exists?
Opinions:
Majority - Goldman, J.S.C.
No. The involuntary commitment of a person with active tuberculosis does not violate due process or the ADA when it is proven by clear and convincing evidence that the person is an 'actual menace to the community' and commitment is the least restrictive means of isolation. The state has a compelling interest under its police power to protect public health from communicable diseases. However, civil commitment is a significant deprivation of liberty that requires robust due process protections, which the court found were met here. The court analogized to the procedural safeguards for the involuntary civil commitment of the mentally ill, which require notice, the right to counsel, the right to confront witnesses, and proof by clear and convincing evidence that the person poses a danger to others. Furthermore, the Americans with Disabilities Act (ADA), which covers individuals with TB, permits actions necessary to neutralize a 'direct threat' to the health of others when no 'reasonable accommodation' (i.e., a less restrictive alternative) can eliminate the risk. Because J.S. had active TB, was contagious, homeless (lacking a place for self-isolation), and had a history of non-compliance, hospital commitment was the least restrictive means available to protect the public, thereby satisfying both constitutional and statutory requirements.
Analysis:
This decision is significant for modernizing an archaic public health statute to meet contemporary constitutional due process standards and the requirements of the Americans with Disabilities Act. By importing the procedural framework from mental health civil commitments, the court created a durable legal standard for public health detentions that balances state police power with individual liberty. The ruling establishes that public health quarantines are not absolute and must be justified through a rigorous, individualized judicial process. This case provides a critical framework for handling future public health crises involving communicable diseases and non-compliant individuals, ensuring that any deprivation of liberty is a last resort based on clear evidence of danger.
